Understanding Grief and Loss

No one is exempt from grief and loss, and traumatic events that create these feelings happen many times over the course of one’s life. Grief is a feeling of irreparable loss of someone or something, and marked by overwhelming emotions of sadness, regret, disbelief, and hopelessness. With time, these acute feelings will start to dissipate and a return to normal activities a frame of mind can resume. If the person is unable to properly process their grief, and the same emotions persist at the same volume and for an extended period of time, a complicated grief disorder is diagnosed and should be treated with clinical modalities.

The Five Stages of Grief

In most cases of grief – simple or complicated – a person will go through five predictable stages between the time of the loss and the eventual return to normalcy. These are:

Denial

Anger

Bargaining

Depression

Acceptance

Unresolved Grief and Substance Use Disorder

Drowning the Sorrows, Feeding the Compulsion
When a person experiences complicated grief – intense and unrelenting – and does not seek effective counseling, he or she may use alcohol or drugs as a means of coping with overwhelming feelings and to dull the pain, anger, guilt, and shame associated with the loss. For a person with an addictive predisposition, the effects of grief and loss can be far more intense and debilitating.

Tom’s Story…

Tom (name changed) was always a heavy drinker even prior to the unexpected death of his wife. Normal nights, he could easily go through a 12-pack of beer, still function in his full-time job, and be a loving husband. When his wife Barbara (name changed) died from cancer, his grief was all-consuming and unmanageable. He quickly graduated to a liter of gin each night, could not work nor participate in basic activities like showering or grocery shopping.

The vicious cycle of grief response and excessive drinking eventually led him to inpatient primary treatment for alcoholism. Through clinical sessions with a therapist, integrated with rigorous 12-Step work, Tom was able to understand and process his feelings of loss, sadness, anger, and regret and learn how to cope and remain abstinent.

Without clinical grief therapy to help Tom process his intense feelings, Tom would have fallen into old drinking patterns in order to medicate away unprocessed negative emotions associated with his wife’s death. Without the daily design for living he developed through his Step work, Tom would have had no clear direction on how to live without alcohol, and might very well have relapsed. Today, Tom is 5 years sober, remarried, and has been able to move on while still enjoying happy memories of his life with Barbara.

Complicated Grief Therapy for Substance Use Disorders

Understanding Grief, Processing Grief, and Letting it Go
Complicated Grief Therapy (CGT) is an effective clinical intervention that is informed by cognitive, behavioral, and interpersonal work with a client. It is utilized when a client has had a prolonged and all-consuming relationship with his or her grief. Through talk and cognitive therapies in both individual and group settings, the client is able to identify the negative emotional and behavioral effects of their grief, and learn to process them more positively.

Grief and loss are often inextricably woven into the story of drug and/or alcohol addiction, derivative of traumas experienced previous to – or as a result of – the substance use disorder. The addict often feels consumed by an unrelenting complicated grief that triggers a compulsion to use. In CGT, the client struggling with substance use disorder is able to discuss and share their grief, examine the emotions resulting from the loss, and develop coping mechanisms for these potential triggers for substance use.